Health and Medical Administration Commons^™

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

How Exemplary Chief Nurse Executives Utilize The Six Domains Of Conflict Transformational Strategies To Establish Common Ground And Produce Breakthrough Results, Michael Thompson

Dissertations

Purpose: The purpose of this phenomenological method study was to identify and describe strategies that exemplary chief nurse executive leaders use to identify and establish common grounds to produce breakthrough results in healthcare by using the six domains of transformational conflict strategies: collaboration, communication, emotional intelligence, ethical behaviors, problem solving, and shared interest.

Methodology: As a part of the thematic phenomenological study, the research identified and described the lived experiences of eight exemplary chief nurse executive leaders in health care who used conflict transformational strategies to find common ground to produce breakthrough results. The target population for the study included …

Healthcare Employees’ Perceptions On The Effects Of Internal Audits, Jeremy Mason

MUSC Theses and Dissertations

With limited research on the perceptions of internal audits, this study was

able to add more literature to the subject. The study’s aim was to survey

employee perceptions of the effects of internal audits. This study will provide organizations with results pertaining to how employees perceive the usefulness of internal audits. The study team conducted a single-site study and invited the healthcare organization's employee population to participate in the study. The survey captured 40 responses from 361 invitees (11%). The survey explored the perceptions on six categories of internal audits: Efficiency, Ethical Behavior, Effectiveness, Auidotr-Auditee Relationship Exchange, Learning from Audit, …

Exploring And Identifying Healthcare Leaders Competencies Required For Effective Decision Making In A High Velocity Environment To Achieve Sustainability Under The Regulatory Compliance Tenets Of The Patient Protection Affordable Care Act, Sylvester Foote

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Healthcare organizations face challenges in efficiently accommodating increased participant demands with limited resources and capacity. The modern reimbursement environment prioritized the maximization of operational efficiency and the reduction of unnecessary cost (i.e., waste) while maintaining or improving quality. As healthcare organizations adapt, significant pressures are placed on leaders to make difficult operational and budgetary decisions (Hamrock, Eric, et al., 2013).

As healthcare goes through this transformation within its high velocity environment defined as environments in which there is rapid and discontinuous change in demand, competitors, technology and /or regulations, such that information is often …

Using Critical Incident Debriefing After Code Blue Events To Support Registered Nurses, David L. Boyd

Doctor of Nursing Practice (DNP) Projects

Using Critical Incident Debriefing after Code Blue Events to Support Registered Nurses

Section I: Abstract

Background: During a code blue event (CBE), the environment becomes highly stressful and intense. Nurses rapidly transition from performing life-saving procedures on their patients to carrying out their usual duties. Without proper debriefing, nurses cannot properly process their emotions leading to increased burnout and secondary traumatic stress (Stamm, 2010).

Local Problem: In 2021, the nurses at Providence Saint John’s Health Center (2021a) responded to 110 CBEs, a 43% increase from 2020. Without a process for critical incident debriefing (CID), these nurses were exposed to trauma …

Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne

Seton Hall University Dissertations and Theses (ETDs)

Burnout is a problem among workers in Nigeria, especially among nurses (Ozumba, & Alabere, 2019). This study examined whether there was a significant relationship between the employee perception of the servant leadership behaviors of the nurse supervisor and the employee’s self-rating of burnout: exhaustion and disengagement, and servant leadership behaviors of the nurse supervisor, and engagement: vigor, dedication, and absorption. Exhaustion refers to an intensive physical, affective, and cognitive strain while disengagement refers to the distancing of oneself from one’s work, and experiencing negative attitudes toward the work object, work content, or one’s work in general (Demerouti et al., 2001). …

Early Sepsis Recognition Saves Lives:Optimizing Sepsis Care In A Medical-Surgical Telemetry Unit, Genevieve Kales

Master's Projects and Capstones

Abstract

Problem: This Quality Improvement project aims to improve sepsis bundle education to reduce mortality and morbidity rates related to septicemia in a Medical-Surgical Telemetry Unit at a San Francisco Bay Area Hospital, Hospital Z.

Context: The Quality Improvement project occurred in a Medical-Surgical Telemetry unit at Hospital Z. This Unit is a 32 beds unit with an increased mortality and mobility rate with decreased sepsis bundle compliance.

Intervention: Collect active and passive observational data in the microsystem. Data collection was conducted through anonymous self-administered questionnaires to the registered nurses on the unit. No intervention was implemented at this time. …

Feature Selection From Clinical Surveys Using Semantic Textual Similarity, Benjamin Warner

McKelvey School of Engineering Theses & Dissertations

Survey data collected from human subjects can contain a high number of features while having a comparatively low quantity of examples. Machine learning models that attempt to predict outcomes from survey data under these conditions can overfit and result in poor generalizability. One remedy to this issue is feature selection, which attempts to select an optimal subset of features to learn upon. A relatively unexplored source of information in the feature selection process is the usage of textual names of features, which may be semantically indicative of which features are relevant to a target outcome. The relationships between feature names …

Non-Opioid Pain Relief: Use Of Vitamin D In Central Appalachia, Christina Brown, Karen Lasater, Teresa Tyson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Overdose deaths have exceeded US war fatalities since WWII. Central Appalachia faces high substance use rates and poor health determinants. The opioid epidemic costs $740 billion annually. Providing 100 million chronic pain sufferers alternative pain control is efficacious, equitable, and reduces opioids. The author collaborated with a nurse-led mobile clinic in Central Appalachia to identify evidence-based non-opioid pain relief options for practice translation. In patients with hypovitaminosis D, the body will increase parathyroid hormone production to absorb calcium resulting in skeletal or muscular pain. Vitamin D’s steroid properties reduce inflammation by dampening proinflammatory cytokines. Framework: The Johns Hopkins Nursing …

Early Onset Hypertension Objective Structured Clinical Examinations, Katrina Morace

Doctoral Projects

Hypertension is known as a condition in which raised blood vessel pressure persists. On a normal day, the pressure can rise and fall causing damage to the heart. When the pressure stays at higher readings, damage can be caused to the heart and can also lead to additional health problems. Another word for high blood pressure is hypertension. The blood is carried to all body parts from the heart by the arteries. The harder the heart pumps the higher the blood pressure (Centers for Diseases Control and Prevention [CDC], 2020). When hypertension is not diagnosed and treated at an early …

Converting Paper Faxes To Electronic Faxes To Improve Patient Care, Decrease Paper Burden, And Improve Staff And Provider Satisfaction: A Quality Improvement Project, Stephanie Green, Amanda Lindenberg

Research Days

Problem Statement/Question: Reliance on provider and administrative staff to be physically present at Adele Hall creates delays in delivery of completed documentation. Delays of up to 7-14 days are possible. Delays in completion result in outside offices resending (wasted duplication of work) requests and delay downstream delivery of equipment/services, ultimately negatively impacting patient care. Over a 2-week period in November 2022, it took at average of 6.08 days for time to completion of requests. Over a 4-week period in August 2022, divisional outgoing faxes in response to requests averaged 79.5 per week. In addition, reliance on hardcopies of requests increases …

A Multifaceted Approach To Promoting Speaking Up Behavior In A Community Hospital, Carrie Carls

Doctor of Nursing Practice Projects

Introduction

This project describes results of a multifaceted approach to promoting Speaking Up Behavior (SUB) among nurses in a community hospital. Patient safety outcomes, perception of healthy work environment, and nurse retention are connected to caregiver communication.

Methods

Interventions included development of a structured SUB communication and debriefing tool, SUB administrative policy, leadership rounding and verbal support for SUB, formal recognition of SUB, and SUB education including role-playing activities. Cross-sectional surveys evaluating nurse comfort and confidence with SUB using validated tools were implemented before and after the multifaceted interventions.

Results

The bedside nurse voluntary turnover rate reduced from 14.5% to …

Advanced Care Planning In Primary Care, Kaylee Beals, Amanda Merriman

Doctor of Nursing Practice Projects

In Illinois, the do-not-resuscitate (DNR) form that is legally binding in all healthcare facilities is known as the Practitioner Orders for Life-Sustaining Treatment (POLST) form. The Patient Self-Determination Act (PSDA) of 1991 mandates only certain facilities to discuss advanced care planning (ACP). Primary care offices are not included in this mandate. Therefore, no structured process exists for primary care providers to identify patients who may benefit from ACP discussions. The purpose of this Doctor of Nursing Practice (DNP) project was to initiate conversations about ACP with patients 55 years and older in a primary care office and complete POLST forms …

Development Of Neuraxial Anesthesia Educational Videos For Nurse Anesthesia Students, Mackenzie Schutt, Kaylie Lajeunesse

Doctor of Nursing Practice Projects

Development of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students

Kaylie LaJeunesse, BSN, RN, SRNA & Mackenzie Schutt, BSN, RN, SRNA

Performance and evaluation of anesthetic procedures, specifically neuraxial anesthesia, are core components of nurse anesthesia curriculums. Teaching methods must provide nurse anesthesia students with the proper tools and knowledge to perform skills confidently and proficiently. Traditional teaching methods have fallen short of providing the necessary instruction for optimal student success. Incorporating video-learning resources on neuraxial anesthesia into course curriculums can significantly improve nurse anesthesia practice by better-preparing students for the clinical setting. Video learning increases student engagement and facilitates …

Utilizing The Anatomage Virtual Dissection Table For Learning Neuroanatomical Structures In Nurse Anesthesia Programs, Domenica Camaci-Douleh, Nicole Gorris

Doctor of Nursing Practice Projects

Certified registered nurse anesthetists are responsible for developing expertise in neuraxial anesthesia. A thorough understanding of anatomy and physiology is essential in the performance of subarachnoid and epidural blocks. Although cadaveric dissection is considered the gold standard for learning anatomy, student use of cadavers can become limited due to supervisory, ethical, accessibility, and financial constraints (Periya and Moro, 2019). In recent years, the evolution of technology has produced a virtual option for cadaver dissection (Washmuth et al., 2020). The anatomage virtual dissection table is a tool that could be used to increase knowledge of neuroanatomical structures and their spatial relationships …

Body Dysmorphic-Induced Androgenic Anabolic Steroids Usage And Its Association With Mental Health Outcomes: A Systematic Review, Ahmed Gawash, Hasan Zia, David Lo

Stratford Campus Research Day

This systematic review on body dysmorphic disorder (BDD), anabolic-androgenic steroid (AAS) use, and mental health outcomes aim to examine the relationship between them. While looking at prior research, it has been suggested that individuals with BDD may be more likely to abuse AAS due to their preoccupation with appearance but, unfortunately, AAS use may worsen mental health issues in this population and exacerbate the issue. This systematic review will also discuss treatments that will help mitigate the effects of AAS on individuals with BDD. The review will include only published literature from a variety of databases such as PubMed, Scopus, …

Healthcare Disparities In The Lgbtqia+ Community: A Scoping Review Of Community Vs Provider Experiences, Uttara Hardikar, Alisha Vincent, Venkateswar Venkataman, Millicent Channell

Stratford Campus Research Day

Background: It is well-established that healthcare disparities exist in the LGBTQIA+ community. The divide is a growing concern exacerbated by recent changes in the healthcare and sociopolitical climate. To eliminate this divide and find ways to deliver better outcomes to the LGBTQIA+ is a dire need. This report analyzes the possible reasons from the community as well as the providers perspective, with a goal to find best practices that could be implemented in both components.

Methods: A scoping literature review was carried out as described below to collect perspectives from both sides: patients as well as providers.

Results: From patient …

Brief Review: Low Frequency Event Charts (G-Charts) In Healthcare, James Espinosa, David Ho, Alan Lucerna, Henry Schuitema

Stratford Campus Research Day

The ability to determine if a change in a system is actually an improvement—or worsening in function—is one of the essential desiderata of quality improvement efforts. There are many ways to look at the issue. A special problem occurs when the event being studied is low frequency by nature. By way of example, patient falls in a given hospital or division of a hospital may occur in a way that is low frequency—yet each event is important. Process engineering has developed an approach to low frequency events. Part of this approach may involve specialized charts that look at the “time-between-events”—as …